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Objective:To investigate the influential factors for poor prognosis in patients with acute myocardial infarction and construct a risk prediction nomograph model.Methods:A total of 173 patients with acute myocardial infarction who received treatment in The First People's Hospital of Huzhou from June 2018 to June 2021 were included in this study. They were divided into a good prognosis group ( n = 130) and a poor prognosis group ( n = 43) according to the follow-up results at 6 months after developing acute myocardial infarction. The clinical data of the two groups were compared using retrospective analysis methods. The potential influential factors were preliminarily screened using LASSO regression analysis. The influential factors of poor prognosis for acute myocardial infarction were investigated using logistic regression analysis. The risk prediction nomograph model was constructed using the "rms" package of R 4.2.6 language. The discriminability, calibration, and effectiveness of the model were evaluated by drawing the receiver operating characteristic curve, calibration curve, and decision curve. Model validation was conducted internally using the Bootstrap method (repeated sampling 1 000 times). Results:There were significant differences in the culprit vessel, Killip classification, vessel opening time, cardiac troponin I (cTnI), hypertension history, N-terminal pro-brain natriuretic peptide (NT-proBNP), diabetes history, creatinine, hyperlipidemia history, left ventricular ejection fraction, smoking history and creatine kinase isoenzymes-MB between the two groups (all P < 0.05). Seven potential influential factors were screened using LASSO regression model, including diabetes history, infarcted vessel anterior descending branch, Killip IV, vascular opening time, cTnI, NT-proBNP, and left ventricular ejection fraction. Logistic regression analysis showed that vascular opening time ( OR = 0.171, 95% CI: 0.053-0.548, P = 0.003), cTnI ( OR = 0.201, 95% CI: 0.079-0.510, P = 0.001), left ventricular ejection fraction ( OR = 1.469, 95% CI: 1.167-1.847, P = 0.001), NT-proBNP ( OR = 0.996, 95% CI: 0.993-1.00, P = 0.025) were independent influential factors of poor prognosis in patients with acute myocardial infarction (all P < 0.05). Linear regression analysis results indicate that the regression model did not exhibit significant multicollinearity (variance inflation factor < 10). Based on the four influential factors identified by logistic regression analysis, a nomogram model for predicting the poor prognosis of patients with acute myocardial infarction was developed. The area under the receiver operating characteristic curve was 0.979 [95% CI (0.959, 0.999)], and the consistency index was 0.934. The calibration curve of the model was close to the ideal curve. Decision curve analysis revealed that when the probability threshold predicted by the model ranged from 0.61 to 0.99, the predictive value of the model was superior. Conclusion:Factors influencing the poor prognosis of acute myocardial infarction include the time of vessel opening, cTnI, NT-proBNP, and left ventricular ejection fraction. The constructed nomogram model demonstrates good efficacy in predicting the poor prognosis of patients with acute myocardial infarction and can provide some reference for clinical doctors and nurses to identify patients with poor prognosis as soon as possible.
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Objective:To study the effect of liraglutide on the forkhead box O3a (forkhead box O3a, FoxO3a) /Wnt signaling pathway and vertebral bone density in osteoporotic rats.Methods:Female Sprague-dawley rats were divided into sham operation group, model group, and liraglutide intervention group according to the random number table method, with 10 rats in each group. Both the model group and the intervention group used bilateral oophorectomy to establish an osteoporosis model. The intervention group was injected subcutaneously with liraglutide every day, and the sham operation group and the model group were given an equal volume of normal saline. After 12 weeks of continuous administration, the bone mineral density and bone biomechanics were measured, the serum osteoprotegerin, anti-tartrate acid phosphatase, and osteocalcin levels were detected by enzyme-linked immunosorbent assay, and the O3a/Wnt pathway was detected by Real-time PCR technology. The expression level of mRNA was detected by Western blot to detect the expression level of related proteins in the O3a/Wnt pathway.Results:The bone mineral density levels of L4,5 (0.33±0.04 vs 0.18±0.03) and left and right femurs (0.37±0.05 vs 0.23±0.04 0.35±0.04 vs 0.24±0.03) of the successfully modeled rats were significantly lower than those of the sham operation group ( P<0.05) . After 12 weeks of treatment, the differences in the maximum bone load, three-point bending stress, bone density and elastic modulus of the three groups of rats were statistically significant. Among them, the sham operation group had the highest level of each index (36.53±5.23, 154.13±6.27, 0.34±0.04, 3 102.34±160.44) , followed by the intervention group (19.37±4.32, 141.54±6.58, 0.18±0.03, 2 270.18±145.53) and the model group in turn (26.17±4.68, 147.56±5.84, 0.28±0.03, 2 804.24±140.42) ( P<0.05) . There were statistically significant differences in the levels of serum osteoprotegerin, anti-tartrate acid phosphatase and osteocalcin among the three groups. Among them, the osteoprotegerin (Sham operation group vs model group vs intervention group: 7.53±0.63 vs 4.57±0.42 vs 6.15±0.61) of the sham operation group was significantly higher than that of the intervention group and the model group. The anti-tartrate acid phosphatase (Sham operation group vs model group vs intervention group: 14.34±2.87 vs 19.53±3.52 vs 15.96±3.14) and osteocalcin levels (Sham operation group vs model group vs intervention group: 0.84±0.09 vs 1.13± 0.12 vs 0.95± 0.08) of rats The factor was significantly lower than that of the intervention group and model group ( P<0.05) . The mRNA and protein expression levels of FoxO3a, Wnt2, and β-catenin in the three groups of rats were significantly different. Among them, Wnt2 and β-catenin in the sham operation group were significantly higher than the intervention group and model group, and FoxO3a was significantly lower than the intervention group and model Group ( P<0.05) . Conclusion:Liraglutide can increase bone density and improve bone biomechanics by activating O3a/Wnt signal, thereby effectively treating osteoporosis.
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Objective To explore the feasibility and effectiveness of aesthetic restoration of caries of mandibular deciduous incisors with strip crown form of maxillary deciduous incisors.Methods A total of 64 patients (202 teeth) with symmetrical caries of bilateral mandibular central incisors or lateral incisors were randomly selected.The opposite maxillary incisors were restored with strip crowns form and the opposite incisors were restored with resin composite.The effects of the two methods and the incidence of complications were compared three months,six months and twelve months after treatment.Results Three months after treatment,there was no significant difference in the success rate between the two groups.Six months after treatment,there was significant differencein the marginal adaptation between the two groups (x2 =3.919,P =0.048);12 months after treatment,there was significant difference in the restoration integrity of the two groups and the incidence of secondary caries (x2 =5.027,P =0.025;secondary caries x2 =4.369,P =0.037).Conclusions The strip crown form of maxillary primary incisors can be used for aesthetic restoration of caries of mandibular primary incisors,and its effect is better than that of direct resin filling.The strip crown form for mandibular primary incisors needs to be developed and produced urgently.
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Objective To study the clinical effect of orthopedic-orthodontic treatment in crossbite in deciduous dentition through cephalmetric analysis. Methods 12 children with crossbite in deciduous dentition were enrolled in treatment group. Control group included 8 patients with normal deciduous dentition. Modified reverse headgear was used in each patient in the treatment group. Orthodontic force was a-bout 2. 94-4. 90 N (300-500 g) , and the direction of force was under occlusion plane for 37 degree. Each patient wore reverse headgear for 10 hour per day. Orthodontic treatment lasted for 6 months, and then orthodontic treatment began at once. Orthodontic treatment was not over until crossbite was corrected. The cephalmetric change was compared between two groups before treatment (T1) , after orthopedic treatment (T2)and after orthodontic treatment (T3). The effect of orthopedic-orthodontic treatment was analyzed in two group. Results Crossbite was corrected successfully in all patients in the treatment group. After treatment, A point moved forward by 2. 8mm, Is-FHp increased 8. 38 mm, ＜SNA increased 2. 65, incisors in mandible moved backward a little bit. All these changes were statistical different as compared with those in the control group. Conclusion Skeletal and dental deformity are improved progressively after combined orthopedic-orthodontic treatment. It is recommended to perform orthopedic-orthodontic therapy in skeletal crossbite in deciduous dentition.